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Valsalva Maneuver

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182. Assessment of Gravid Cervix

test should be avoided. A cervical stress test is performed by either applying transfundal pressure while scanning transvaginally or examining the patient during a Valsalva maneuver or coughing or while standing [28,29]. Transfundal pressure is considered the most effective stress technique in eliciting cervical changes during the active assessment of the ACR Appropriateness Criteria ® 4 Assessment of Gravid Cervix cervix. It is defined as applying moderate pressure on the maternal abdomen (...) at the internal cervical os may be added. In a postcerclage patient it is often helpful to describe the CL in relationship to the cerclage sutures. Transvaginal Ultrasound with a Cervical Stress Test If the cervix remains normal in appearance, a “cervical stress test” can be applied to elicit a dynamic cervix. It is recommended that this maneuver only be carried out in locations with provisions for labor and delivery. If the cervix is already dilated, shortened, or dynamic in appearance, a cervical stress

2014 American College of Radiology

183. Pelvic Floor Dysfunction

enteroceles. ??? MR defecography with rectal contrast 9 Imaging patient in the seated position is preferred, if possible. O US pelvis transperineal 8 O MRI pelvis dynamic with rectal contrast 7 Dynamic refers to imaging the patient during rest and strain maneuvers. Encourage adequate Valsalva effort by patient. Avoid overdistended bladder. Lack of rectal contrast may result in suboptimal study. Vaginal contrast may also be given. O X-ray fluoroscopic defecography 5 Lack of intraluminal contrast (...) : Pelvic Floor Dysfunction Variant 2: Urinary dysfunction. Involuntary leakage of urine, frequent urination, urgency. Straining to void, incomplete voiding, splinting, or digital maneuvers to void. Radiologic Procedure Rating Comments RRL* US pelvis transperineal 9 O MRI pelvis dynamic with rectal contrast 8 Dynamic refers to imaging the patient during rest and strain maneuvers. Encourage adequate Valsalva effort by patient. Avoid overdistended bladder. O MR defecography with rectal contrast 7 Consider

2014 American College of Radiology

185. Type 1 Diabetes Mellitus and Cardiovascular Disease: A Scientific Statement From the American Heart Association and American Diabetes Association

of cardiac autonomic neuropathy in T1DM vary widely, in part because of differing definitions and methods of testing (heart rate variability, response to Valsalva maneuver, handgrip, multiple versus isolated abnormalities, etc). Cardiac neuropathy may affect as many as ≈40% of individuals with T1DM. Time Course of CVD Events In all patients, those with DM included, the clinical presentation of CHD is very late in the pathophysiological process of atherosclerosis. This is suggested by the vascular

2014 American Heart Association

186. Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardiovascular Disease in Healthy General Populations of Young People (12?25 Years of Age)

(vasovagal) origin; of particular concern when occurring during or after physical exertion. ‡ Refers to heart murmurs judged likely to be organic and unlikely to be innocent; auscultation should be performed with the patient in both the supine and standing positions (or with Valsalva maneuver), specifically to identify murmurs of dynamic left ventricular outflow tract obstruction. § Preferably taken in both arms. Modified with permission from Maron et al. Copyright © 2007, American Heart Association, Inc (...) , in which a systolic heart murmur (indicative of left ventricular outflow obstruction) should be audible at rest in 25% of individuals and in an additional 50% with performance of the Valsalva maneuver or in the standing position. , Also, at-risk individuals may fail to disclose potentially important symptoms such as syncope or chest pain. Nevertheless, it should be underscored that an important proportion of adolescents and young adults at risk for SD with primary structural or electrophysiological

2014 American Heart Association

187. Structural changes in puborectalis muscle after vaginal delivery. (PubMed)

Structural changes in puborectalis muscle after vaginal delivery. To evaluate the structural composition of the puborectalis muscle before and at several timepoints after first vaginal delivery, by the use of echogenicity and area measurements, in order to explore its recovery.Twenty nulliparous women with a singleton pregnancy underwent 3D/4D transperineal ultrasound assessments at rest, on pelvic floor muscle contraction and on Valsalva maneuver at 12 weeks' gestation and at 1 day and 1, 2, 3 (...)  weeks after delivery. Although not statistically significant, a decrease in MEP was observed between 3 and 4 weeks after delivery for all maneuvers. PMA at rest and on Valsalva maneuver remained constant after delivery.When compared with measurements taken during pregnancy, a sharp decrease in MEP was observed soon after vaginal delivery, which was most likely caused by stretch trauma to the puborectalis muscle and subsequent formation of (micro) hematoma and edema. Subsequent increases in MEP may

2018 Ultrasound in Obstetrics and Gynecology

188. [Microscopic spermatic vein ligation for the treatment of varicocele]. (PubMed)

groups of patients in the internal diameters of the spermatic vein during eupnea and Valsalva maneuver, the reflux time of the spermatic vein, blood flow parameters of the testicular artery, and semen quality before and at 3 months after surgery.At 3 months after surgery, the experimental group, as compared with the control, showed significantly decreased reflux time of the spermatic vein ([0.41 ± 0.10] vs [1.08 ± 0.10] s, P <0.05) and peak systolic velocity (9.26 ± 1.35 vs 10.64 ± 1.28, P <0.05 (...) ) and resistance index (0.52 ± 0.03 vs 0.61 ± 0.03, P <0.05) of the testicular artery but markedly increased internal diameters of the spermatic vein during eupnea ([1.63 ± 0.07] vs [1.59 ± 0.06] mm, P <0.05) and Valsalva maneuver ([1.72 ± 0.05] vs [1.68 ± 0.07] mm, P <0.05), sperm concentration ([46.84 ± 5.24] vs [35.35 ± 4.26] ×10⁶/ml, P <0.05), sperm motility ([63.75 ± 7.73] vs [53.87 ± 6.46] %, P <0.05), and total sperm count ([89.54 ± 7.95] vs [75.24 ± 8.43] ×10⁶/ml, P <0.05).Microscopic spermatic vein

2018 Zhonghua nan ke xue = National journal of andrology

189. Randomized controlled trial of chest tube removal aided by a party balloon. (PubMed)

, history of chronic lung disease, Glasgow Coma Scale < 13, latex allergy, or tracheostomy. Participants were randomly allocated by randomized block design into 4 groups using different Valsalva maneuvers: group A: classic inspired, group B: classic expired, group C: balloon-inspired; and group D: balloon-expired. The primary and secondary outcomes were recurrent pneumothorax and respiratory complications. Results Forty-eight tube thoracostomies were randomized for analysis; 4 patients had bilateral (...) the Valsalva maneuver correctly during full inspiration may be the method of choice for removing thoracostomy tubes. Using a party balloon forces the patient perform the Valsalva maneuver adequately and is simpler to explain.

2018 Asian cardiovascular & thoracic annals

190. Effects of aerobic or resistance exercise training on cardiovascular autonomic function of subjects with type 2 diabetes: A pilot study. (PubMed)

during a standardized Valsalva maneuver using two indexes, b2 and b4, considered an expression of baroreceptor sensitivity and peripheral vasoactive adaptations during predominant sympathetic and parasympathetic drive, respectively. After training, the LF/HF ratio, which summarizes the sympatho-vagal balance in HRV control, was similarly decreased in the AER and RES groups. After AER, b2 and b4 significantly improved. After RES, changes of b2 were of borderline significance, whereas changes of b4 did

2018 Nutrition, metabolism, and cardiovascular diseases : NMCD

191. Effects of core strength training on core stability (PubMed)

Effects of core strength training on core stability [Purpose] To investigate the effects of core strength training on core stability with and without the Valsalva maneuver. [Participants and Methods] Twenty-four students were randomly assigned to the training and control groups. Students in the training group undertook a 4-week training program that included exercises for the transverse abdominis, multifidus, diaphragm, and pelvic floor muscles, whereas students in the control group performed (...) their usual activities. Participants were required to perform four types of task with and without the Valsalva maneuver. Seated stabilometry was assessed according to the center of pressure (COP). [Results] In the training group, the rectus area in the quiet sitting position with the Valsalva maneuver was enlarged and the length of trajectory during a sudden perturbation task was decreased. No significant changes to the COP were seen in the control group. [Conclusion] Some parameters of core stability

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2018 Journal of physical therapy science

192. Relationships Between 3-Dimensional Transperineal Ultrasound Imaging and Digital Intravaginal Palpation Assessments of the Pelvic Floor Muscles in Women With and Without Provoked Vestibulodynia. (PubMed)

assessment in women with genito-pelvic pain and penetration disorders.To study the relations between measures of PFM morphology and function assessed using 3-dimensional (3D) TPUSI and PFM assessment through intravaginal palpation.77 nulliparous premenopausal women with (n = 38) and without (n = 39) PVD participated. 3D TPUSI was used to measure levator hiatal dimensions at rest, at maximal voluntary contraction (MVC) of the PFMs, and at maximal Valsalva maneuver (MVM). Intravaginal palpation was used

2018 Journal Of Sexual Medicine

193. Laparoscopic Lateral Suspension With Mesh & Sacrocervicopexy for the Treatment of Uterine Prolapse

over 15 mm are clinically relevant Change from baseline bladder neck mobility measurements at 12th month. [ Time Frame: 12 months for each participant ] Urethral rotation (degree) between rest and valsalva maneuver states Failure (%) [ Time Frame: 12 months for each participant ] Failure is defined by any recurrence of prolapse, mesh erosion and need for additional surgery Complications [ Time Frame: 12 months for each participant ] Perioperative and postoperative complications including Severe

2018 Clinical Trials

194. Indicor Validation

, repeated at three time points before and after the catheterization procedure. The Indicor indirectly measures LVEDP by calculating a value from finger photoplethysmography (PPG) waveforms that will be recorded while the patient performs a Valsalva maneuver. Participants baseline characteristics will be gathered from the electronic medical record, including history of coronary artery disease, heart failure, hypertension, diabetes, or lung disease; list of blood pressure medications; serum markers (...) of kidney function; and echocardiogram measurements including ejection fraction. These parameters will be used to assess relevance to the calculation of LVEDP by Indicor. The first Indicor measure will be conducted before the catheterization procedure. PPG probes will be attached to participants' first or second finger. Participants will be asked to strain as if having a bowel movement (Valsalva maneuver) for 10 seconds. Participants will blow into a pressure transducer that measures and displays

2018 Clinical Trials

195. Aging Alters the Relative Contributions of the Sympathetic and Parasympathetic Nervous System to Blood Pressure Control in Women. (PubMed)

nervous system in control of blood pressure with age. Muscle sympathetic nerve activity (microneurography, peroneal nerve), heart rate (HR), and blood pressure were recorded before and during incremental doses of TMP camsylate until ganglionic blockade was achieved (absence of muscle sympathetic nerve activity and <5-bpm increase in HR during a valsalva maneuver; final TMP dose, 1-7 mg/min). HR variability was analyzed from the ECG waveform (WinCPRS). The dose of TMP required to achieve ganglionic

2018 Hypertension

196. Subarachnoid hemorrhage after transient global amnesia caused by cerebral venous congestion: case report. (PubMed)

Subarachnoid hemorrhage after transient global amnesia caused by cerebral venous congestion: case report. Transient global amnesia is reported to be caused by cerebral venous congestion. Internal jugular venous flow reversal in particular with the Valsalva maneuver leads to cerebral venous congestion. In addition, Valsalva maneuver can also induce subarachnoid hemorrhage. Transient global amnesia and subarachnoid hemorrhage might have common a pathophysiology in cerebral venous congestion.We (...) report here the case of a 57-year-old woman who twice experienced convexal subarachnoid hemorrhage just after straining at stool following an episode of transient global amnesia. Digital subtraction angiography showed left temporal congestion. Left jugular vein ultrasonography revealed reflux with the Valsalva maneuver only in acute phase, indicating transient cerebral venous congestion.Subarachnoid hemorrhage followed by transient global amnesia indicates a common factor between them. Transient

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2018 BMC Neurology

197. Cardiac Autonomic Function and Reactivity Tests in Physically Active Subjects with Moderately Severe COPD. (PubMed)

and gender matched control subjects were evaluated. R-R intervals were collected at rest in supine position. Thereafter, resting autonomic function parameters comprising linear and nonlinear analyses of heart rate variability (HRV) and baroreceptor sensitivity (BRS) were calculated. Autonomic reactivity tests comprising deep breathing (DB), Valsalva maneuver (VM), and head up tilt (HUT) were also performed. The results of this study indicated that resting autonomic function variables were generally

2018 COPD

198. Comparison of Balloon Dilation and Laser Eustachian Tuboplasty in Patients with Eustachian Tube Dysfunction: A Meta-analysis.

dilatation. Review Methods Randomized controlled trials and prospective, retrospective, and 1-arm studies of patients with ETD treated with balloon dilatation or laser tuboplasty were included. Outcome measures were improvement of eustachian tube score (ETS) and tympanometry and Valsalva maneuver results. Results Two retrospective and 11 prospective studies were included (1063 patients; 942 treated with balloon and 121 with laser tuboplasty). Balloon tuboplasty resulted in a significant improvement (...) of ETS (pooled standardized mean difference [SMD], 0.94; 95% confidence interval [CI], 0.23-1.66; P = .009) and, compared with laser tuboplasty, a greater tympanometry improvement rate (pooled event rate = 73% vs 13%; P = .001). Valsalva maneuver improvement rate was not different between the group results (pooled event rate = 67% vs 50%; P = .472). The maximum number of studies that provided outcome data for any one measure was only 4, and sensitivity analysis indicated ETS results may have been

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2018 Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

199. Assessment of fluid responsiveness in spontaneously breathing patients: a systematic review of literature. (PubMed)

Assessment of fluid responsiveness in spontaneously breathing patients: a systematic review of literature. Patients who increase stoke volume or cardiac index more than 10 or 15% after a fluid challenge are usually considered fluid responders. Assessment of fluid responsiveness prior to volume expansion is critical to avoid fluid overload, which has been associated with poor outcomes. Maneuvers to assess fluid responsiveness are well established in mechanically ventilated patients; however, few (...) studies evaluated maneuvers to predict fluid responsiveness in spontaneously breathing patients. Our objective was to perform a systematic review of literature addressing the available methods to assess fluid responsiveness in spontaneously breathing patients. Studies were identified through electronic literature search of PubMed from 01/08/2009 to 01/08/2016 by two independent authors. No restrictions on language were adopted. Quality of included studies was evaluated with Quality Assessment

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2018 Annals of intensive care

200. Pneumocephalus after Tympanomastoidectomy: A Case Presentation (PubMed)

Pneumocephalus after Tympanomastoidectomy: A Case Presentation Pneumocephalus is the presence of air or gas within the cranial cavity. It can occur following otorhinolaryngological procedures. A small pneumocephalus spontaneously heals without any treatment. In severe cases, conservative therapy includes a 30-degree head elevation, avoidance of the Valsalva maneuver, analgesics, osmotic diuretics, and oxygen therapy.A 56-year-old woman was referred to the emergency department due to a severe

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2018 Iranian journal of otorhinolaryngology

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